Comparison of safety and haemodynamic performance between the Avalus™ stented aortic valve bioprosthesis and Magna™ valve in Japanese patients
Tóm tắt
A new stented bovine pericardial valve (Avalus™) has been proven safe and effective with good hemodynamic performance in Western populations. However, its use in Japanese patients is poorly understood. We retrospectively compared the feasibility, safety, and valve haemodynamics between the Avalus™ and Magna™ valves in patients who underwent surgical aortic valve replacement (SAVR).
This study included 87 patients receiving an Avalus™ valve and 387 receiving a Magna™ valve. We evaluated adverse events, outcomes, and valve haemodynamics within 1 year postoperatively. There were no significant differences in any surgical risk scores.
No in-hospital mortality occurred in the Avalus™ group, but two mortality events occurred in the Magna™ group. No pacemaker implantation for complete atrioventricular block was required in the Avalus™ group. There was no significant difference in in-hospital or clinical outcomes between the two groups until 1 year postoperatively. Left ventricular mass index reduction appeared to predominate in the Avalus™ over Magna™ group. There was no significant difference in the mean pressure gradient or effective orifice area of each valve size at 1 week or 1 year between the two groups, apart from the mean pressure gradient of the 23-mm valve at 1 week. Three patients (3.4%) in the Avalus™ group and 39 (10.8%) in the Magna™ group (
The new Avalus™ stented aortic valve bioprosthesis was associated with good in-hospital outcomes and good valve functionality post-SAVR in Japanese patients.
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Tài liệu tham khảo
Klautz RJM, Kappetein AP, Lange R, Dagenais F, Labrousse L, Bapat V, et al. Safety, effectiveness and haemodynamic performance of a new stented aortic valve bioprosthesis. Eur J Cardiothorac Surg. 2017;52:425–31.
Sabik JF 3rd, Rao V, Lange R, Kappetein AP, Dagenais F, Labrousse L, et al. One-year outcomes associated with a novel stented bovine pericardial aortic bioprosthesis. J Thorac Cardiovasc Surg. 2018;156(1368–77):e5.
Akins CW, Miller DC, Turina MI, Kouchoukos NT, Blackstone EH, Grunkemeier GL, et al. Guidelines for reporting mortality and morbidity after cardiac valve interventions. J Thorac Cardiovasc Surg. 2008;135:732–8.
Bonow RO, Brown AS, Gillam LD, Kapadia SR, Kavinsky CJ, Lindman BR, et al. ACC/AATS/AHA/ASE/EACTS/HVS/SCA/SCAI/SCCT/SCMR/STS 2017 Appropriate use criteria for the treatment of patients with severe aortic stenosis: a report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Valve Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Am Soc Echocardiogr. 2018;31:117–47.
Pibarot P, Dumesnil JG. Prosthesis-patient mismatch: definition, clinical impact, and prevention. Heart. 2006;92:1022–9.
Long JS, Ervin LH. Using heteroscedasticity consistent standard errors in the linear regression model. Am Stat. 2000;54:217–24.
Pibarot P, Simonato M, Barbanti M, Linke A, Kornowski R, Rudolph T, et al. Impact of pre-existing prosthesis-patient mismatch on survival following aortic valve-in-valve procedures. JACC Cardiovasc Interv. 2018;11:133–41.
Devereux RB, Wachtell K, Gerdts E, Boman K, Nieminen MS, Papademetriou V, et al. Prognostic significance of left ventricular mass change during treatment of hypertension. JAMA. 2004;292:2350–6.
Lim E, Ali A, Theodorou P, Sousa I, Ashrafian H, Chamageorgakis T, et al. Longitudinal study of the profile and predictors of left ventricular mass regression after stentless aortic valve replacement. Ann Thorac Surg. 2008;85:2026–9.
Villa E, Troise G, Cirillo M, Brunelli F, Tomba MD, Mhagna Z, et al. Factors affecting left ventricular remodeling after valve replacement for aortic stenosis. An overview. Cardiovasc Ultrasound. 2006;4:25.
Hanayama N, Christakis GT, Mallidi HR, Rao V, Cohen G, Goldman BS, et al. Determinants of incomplete left ventricular mass regression following aortic valve replacement for aortic stenosis. J Card Surg. 2005;20:307–13.
Tasca G, Brunelli F, Cirillo M, Dalla Tomba M, Mhagna Z, Troise G, et al. Impact of the improvement of valve area achieved with aortic valve replacement on the regression of left ventricular hypertrophy in patients with pure aortic stenosis. Ann Thorac Surg. 2005;79:1291–6; discussion 6.
Matsumoto Y, Fujita T, Hata H, Shimahara Y, Sato S, Kobayashi J. Hemodynamic performance and durability of mosaic bioprostheses for aortic valve replacement, up to 13 years. Circ J. 2015;79:1044–51.